Long-Term Results of Compressive Brace Therapy for Pectus Carinatum
09 April 2018
09 July 2018
14 September 2018 (eFirst)
Background Pectus carinatum (PC) is one of the most common types of congenital chest wall deformity. Recently, noninvasive compressive brace therapy has been more frequently used than invasive surgical correction to treat PC. Hence, the purpose of this study was to determine the long-term outcome of compressive brace therapy.
Methods We retrospectively reviewed patients with PC who underwent compressive brace therapy between January 2014 and December 2016. All patients underwent a 2-week compression period, in which braces were worn for 20 hours per day, followed by a 6-month maintenance period, in which braces were worn for 12 hours per day. Patient satisfaction was investigated via telephone survey.
Results A total of 320 patients were included in this study. The average age was 13 years, and 280 were males (87.5%). The median follow-up period was 42 months (13–68). Good compliance was observed in 286 patients (89.4%; compliance group). In this group, the initial Haller index significantly increased from 2.20 ± 0.31 to 2.59 ± 0.38 after the 6-month therapy period (p = 0.001). After the 6-month period, 255 patients (89.1%) and 31 patients (12.1%) in the compliance group were very satisfied and satisfied, respectively. Satisfaction at the last follow-up via telephone survey was very satisfied in 250 patients (87.4%) and satisfied in 36 (12.6%). In the compliance group, no patient needed compressive braces again after the therapy period.
Conclusion Given the findings presented in this study, compressive brace therapy appears to be a relatively simple and safe method with good long-term outcome in treating patients with PC.
- 1 Fonkalsrud EW, Anselmo DM. Less extensive techniques for repair of pectus carinatum: the undertreated chest deformity. J Am Coll Surg 2004; 198 (06) 898-905
- 2 Jaroszewski DE, Fonkalsrud EW. Repair of pectus chest deformities in 320 adult patients: 21 year experience. Ann Thorac Surg 2007; 84 (02) 429-433
- 3 Lee RT, Moorman S, Schneider M, Sigalet DL. Bracing is an effective therapy for pectus carinatum: interim results. J Pediatr Surg 2013; 48 (01) 184-190
- 4 Kang DY, Jung J, Chung S, Cho J, Lee S. Factors affecting patient compliance with compressive brace therapy for pectus carinatum. Interact Cardiovasc Thorac Surg 2014; 19 (06) 900-903
- 5 Davis JT, Weinstein S. Repair of the pectus deformity: results of the Ravitch approach in the current era. Ann Thorac Surg 2004; 78 (02) 421-426
- 6 Poullis M. Modified Nuss repair for pectus carinatum. Interact Cardiovasc Thorac Surg 2010; 11 (03) 221-222
- 7 Robicsek F, Watts LT. Pectus carinatum. Thorac Surg Clin 2010; 20 (04) 563-574
- 8 Yüksel M, Bostanci K, Evman S. Minimally invasive repair of pectus carinatum using a newly designed bar and stabilizer: a single-institution experience. Eur J Cardiothorac Surg 2011; 40 (02) 339-342
- 9 Haje SA. Pectus carinatum successfully treated with bracing--a case report. Int Orthop 1995; 19 (05) 332-333
- 10 de Beer SA, de Jong JR, Heij HA. [Dynamic compression brace for pectus carinatum]. Ned Tijdschr Geneeskd 2013; 157 (46) A6796
- 11 Pessanha I, Severo M, Correia-Pinto J, Estevão-Costa J, Henriques-Coelho T. Pectus Carinatum Evaluation Questionnaire (PCEQ): a novel tool to improve the follow-up in patients treated with brace compression. Eur J Cardiothorac Surg 2016; 49 (03) 877-882
- 12 Suh JW, Joo S, Lee GD, Haam SJ, Lee S. Minimally invasive repair of pectus carinatum in patients unsuited to bracing therapy. Korean J Thorac Cardiovasc Surg 2016; 49 (02) 92-98
- 13 de Beer SA, Gritter M, de Jong JR, van Heurn ELW. The dynamic compression brace for pectus carinatum: intermediate results in 286 patients. Ann Thorac Surg 2017; 103 (06) 1742-1749
- 14 Emil S, Sévigny M, Montpetit K. , et al. Success and duration of dynamic bracing for pectus carinatum: a four-year prospective study. J Pediatr Surg 2017; 52 (01) 124-129
- 15 Cortés-Julián G, Bushra-Nuritu HB, Buenfil-Fuentes R, Merino Rajme JA. Modified Ravitch procedure for left Poland syndrome combined with pectus excavatum. Ann Thorac Surg 2017; 104 (04) e337-e339